Northeast Dental Wellness, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11714 Issued in MN

Legal business name

NORTHEAST DENTAL WELLNESS, PA

Practice address

3201 Johnson St. NE
Minneapolis, MN 55418

Phone

(612) 781-6568

Fax

(612) 781-2447

NPI assigned

Jul 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Woojin Kwon, DDS

Title

Owner/Dentist

Phone

(612) 781-6568

Specialties & licenses 1

Addresses

Other names 1

• Misner and Kwon, PA Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Wilson Misner, D.D.S.

  • General Practice Dentistry
  • Minneapolis, MN
  • NPI 1275553273
  NPD (past)
• Walter S Warpeha Jr., DDS, MSD

  • Prosthodontics
  • Minneapolis, MN
  • NPI 1992714232
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1831119437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 JOHNSON ST. NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55418",
            "telephone_number": "612-781-6568",
            "fax_number": "612-781-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 JOHNSON ST. NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55418",
            "telephone_number": "612-781-6568",
            "fax_number": "612-781-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST DENTAL WELLNESS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "WOOJIN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "612-781-6568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Misner and Kwon, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Abigail Rose North
• Northeast Art Therapy LLC
• Northeast Chiropractic PLLC
• Northeast Clinic PLLC
• Northeast College Prep
• Northeast House Inc
• Northeast Psychotherapy
• Northern Path Wellness LLC
• Northern Skies Counseling, LLC
• Northland Bus Service LLC

• General Practice Dentistry in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.